Form990
Click to see attachment
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
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OMB No. 1545-0047
2019
Open to Public Inspection
A For the 2019 calendar year, or tax year beginning 07-01-2019 , and ending 06-30-2020
BCheck if applicable:
CName of organization
Our Lady of the Lake Hospital Inc
 
% AMANDA HYMEL
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
4200 Essen Lane
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Baton Rouge, LA70809
D Employer identification number

72-0423651
E Telephone number

G Gross receipts $ 1,577,907,798
F Name and address of principal officer:
K SCOTT WESTER
4200 Essen Lane
Baton Rouge,LA70809
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.ololrmc.com
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet0928
K Form of organization:  
L Year of formation: 1956
M State of legal domicile: LA
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: TO PROVIDE FOR THE CARE OF THE ILL, INJURED, OR DISABLED PERSONS, AND TO PROVIDE FOR RESEARCH, EDUCATION, AND FOR THE ENHANCEMENT OF HEALTH OF THOSE IN THE COMMUNITY
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 17
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 14
5 Total number of individuals employed in calendar year 2019 (Part V, line 2a) ...... 5 9,263
6 Total number of volunteers (estimate if necessary) ............. 6 181
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 2,506,572
b Net unrelated business taxable income from Form 990-T, line 39 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 10,562,029 102,311,787
9 Program service revenue (Part VIII, line 2g) ......... 1,294,472,705 1,385,296,930
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 51,568,981 28,337,843
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 16,875,204 16,652,275
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 1,373,478,919 1,532,598,835
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 5,411,141 6,257,620
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 485,753,512 562,134,971
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 798,336,182 915,723,726
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 1,289,500,835 1,484,116,317
19 Revenue less expenses. Subtract line 18 from line 12....... 83,978,084 48,482,518
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 2,169,531,783 2,441,820,013
21 Total liabilities (Part X, line 26)............. 1,036,611,162 1,305,615,323
22 Net assets or fund balances. Subtract line 21 from line 20..... 1,132,920,621 1,136,204,690
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2019)
Form 990 (2019)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: INSPIRED BY THE VISION OF ST. FRANCIS OF ASSISI AND IN THE TRADITION OF THE ROMAN CATHOLIC CHURCH, WE EXTEND THE HEALING MINISTRY OF JESUS CHRIST TO GOD'S PEOPLE, ESPECIALLY THOSE MOST IN NEED. WE CALL FORTH ALL WHO SERVE IN THIS HEALTHCARE MINISTRY, TO SHARE THEIR GIFTS AND TALENTS TO CREATE A SPIRIT OF HEALING - WITH REVERENCE AND LOVE FOR ALL OF LIFE, WITH JOYFULNESS OF SPIRIT, AND WITH HUMILITY AND JUSTICE FOR ALL THOSE ENTRUSTED TO OUR CARE. WE ARE, WITH GOD'S HELP,A HEALING AND SPIRITUAL PRESENCE FOR EACH OTHER AND FOR THE COMMUNITIES WE ARE PRIVILEGED TO SERVE.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 908,890,841 including grants of $ 6,257,620 ) (Revenue $ 1,150,495,662 )
THE MEDICAL CENTER PROVIDES QUALITY HOSPITAL AND MEDICAL SERVICES TO ITS PATIENTS. IN THE CURRENT YEAR, SERVICES WERE PROVIDED FOR 194,964 PATIENT DAYS, 195,943 EMERGENCY ROOM VISITS AND 36,656 INPATIENT DISCHARGES. THE MEDICAL CENTER IS AN ACTIVE, CARING MEMBER OF THE COMMUNITIES IT SERVES. IN CARRYING OUT ITS MISSION, THE MEDICAL CENTER HAS ESTABLISHED A POLICY UNDER WHICH IT PROVIDES CARE TO NEEDY MEMBERS OF ITS COMMUNITIES. ADDITIONAL COSTS WERE INCURRED FOR PARTICIPATION IN PROGRAMS WHICH, IN SOME CASES, PAY AMOUNTS LESS THAN THE COST OF PROVIDING SERVICES.
4b (Code:   ) (Expenses $ 205,259,434 including grants of $   ) (Revenue $ 235,128,792 )
OUR LADY OF THE LAKE HOSPITAL'S PHYSICIAN PRACTICE PROVIDES CARE TO THE NEEDY MEMBERS OF ITS COMMUNITIES.
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet1,114,150,275
Form 990 (2019)
Form 990 (2019)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II.........
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part III..
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D, Part IIIClick to see attachment..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D, Part VI. Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XIIClick to see attachment......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....Click to see attachment
15
Yes
 
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I(see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see list of attachments
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
21
Yes
 
Form 990 (2019)
Form 990 (2019)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I ....
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part II...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part III.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....
28b
 
No
c
A 35% controlled entity of one or more individuals and/or organizations described in lines 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable ..
1a
78
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2019)
Form 990 (2019)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
9,263
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see instructions and file Form 4720, Schedule N.
15
 
No
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
Form 990 (2019)
Form 990 (2019)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
17
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
14
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
 
No
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
 
No
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (or 1024-A if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletAMANDA HYMEL5959 S SHERWOOD BLVD   BATON ROUGE,LA70809 (225) 923-2701
Form 990 (2019)
Form 990 (2019)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

See instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W-2/1099-MISC) 		(E)
Reportable compensation from related organizations (W-2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) K SCOTT WESTER......................................................................
CEO
 5.5
.................
50.0 		X   X       0 1,218,510 238,581
(2) DENZIL L MORAES......................................................................
STAFF PHYSICIAN
 40.0
.................
0.0 		        X   1,268,335 0 34,680
(3) Paul M Dampf......................................................................
STAFF PHYSICIAN
 40.0
.................
0.0 		        X   1,209,442 0 39,250
(4) Charles A Smith......................................................................
STAFF PHYSICIAN
 40.0
.................
0.0 		        X   1,084,427 0 38,456
(5) JEFF LIMBOCKER......................................................................
CFO/EVP
 1.0
.................
59.5 		    X       0 898,795 161,397
(6) Paul D Garrett......................................................................
STAFF PHYSICIAN
 40.0
.................
0.0 		        X   1,001,104 0 39,379
(7) NORMAN J DEUMITE......................................................................
STAFF PHYSICIAN
 40.0
.................
0.0 		        X   979,845 0 27,295
(8) STEVEN T GREMILLION......................................................................
SVP, Chief Medical Officer
 40.0
.................
0.0 		      X     953,738 0 31,816
(9) Terrie P Sterling......................................................................
Former COO
 0.0
.................
0.0 		          X 666,848 0 79,152
(10) Stephanie Manson......................................................................
SVP, Chief Operating Officer
 40.0
.................
2.0 		      X     517,230 0 75,493
(11) John Fraiche MD......................................................................
BOARD MEMBER
 40.0
.................
0.0 		X           501,884 0 14,791
(12) Alston Dunbar......................................................................
President of Children's Hospit
 40.0
.................
0.0 		      X     451,974 0 33,303
(13) Nicole S Telhiard......................................................................
SVP Patient Care Services
 40.0
.................
0.5 		      X     371,640 0 76,111
(14) Shaun M Kemmerly......................................................................
VP CHIEF MEDICAL OFFICER
 40.0
.................
0.0 		      X     405,020 0 35,786
(15) DR JAMES CRAVEN......................................................................
BOARD MEMBER/PHYSICIAN
 40.0
.................
0.0 		X           387,926 0 17,076
(16) Laurinda Calongne......................................................................
VP CHIEF ACADEMIC OFFICER
 40.0
.................
0.0 		      X     340,382 0 21,671
(17) Diane Kirby MD......................................................................
BOARD MEMBER/PHYSICIAN
 40.0
.................
0.0 		X           70,096 0 4,515
Form 990 (2019)
Form 990 (2019)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W-2/1099-MISC) 		(E)
Reportable compensation from related organizations (W-2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) YOLANDA DIXON........................................................................
Secretary
 2.0
.......................2.0 		X   X       0 0 0
(19) JULIO MELARA........................................................................
BOARD MEMBER
 2.0
.......................0.5 		X           0 0 0
(20) DR BEN OUBRE........................................................................
BOARD MEMBER
 2.0
.......................0.0 		X           0 0 0
(21) SR EILEEN ROWE........................................................................
BOARD MEMBER
 2.0
.......................2.5 		X           0 0 0
(22) JOHN SELSER........................................................................
Chair
 2.0
.......................1.0 		X   X       0 0 0
(23) William E Balhoff........................................................................
Chairman
 2.0
.......................2.0 		X   X       0 0 0
(24) SR HELEN CAHILL........................................................................
BOARD MEMBER
 2.0
.......................9.0 		X           0 0 0
(25) HENRY EISERLOCH MD........................................................................
BOARD MEMBER
 2.0
.......................0.0 		X           0 0 0
(26) Scott N Hensgens........................................................................
BOARD MEMBER
 2.0
.......................0.0 		X           0 0 0
(27) Harry J Phillips Jr........................................................................
Vice-Chair
 2.0
.......................2.0 		X   X       0 0 0
(28) Michael Crapanzano........................................................................
BOARD MEMBER
 2.0
.......................0.0 		X           0 0 0
(29) John Engquist........................................................................
BOARD MEMBER
 2.0
.......................0.0 		X           0 0 0
(30) Greg Bowser........................................................................
Board Member
 2.0
.......................0.0 		X           0 0 0
(31) Ronnie Daigle........................................................................
Board Member
 2.0
.......................0.0 		X           0 0 0
(32) Robert Landry MD........................................................................
Board Member
 2.0
.......................0.0 		X           0 0 0
(33) Stephen M Toups........................................................................
Board Member
 2.0
.......................0.0 		X           0 0 0
(34) Lowell Stanton........................................................................
Regional CFO
 30.0
.......................15.5 		    X       0 0 0
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 10,209,891 2,117,305 968,752
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet687
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
FMOL HEALTH SYSTEM,
4200 Essen Lane
Baton Rouge,LA70809 		Management Fees 129,606,635
LSUHSC Clinics,
58725 Airline Hwy LSU Unit
Baton Rouge,LA70805 		Medical Services 50,475,977
ANESTHESIOLOGY GROUP ASSOC,
11414 Lake Sherwood Ave North
Baton Rouge,LA70816 		Ansethesiology Servi 15,512,089
MILTON J WOMACK INC,
8400 JEFFERSON HWY
Baton Rouge,LA70809 		Contractor Services 16,794,950
CROTHALL HEALTHCARE INC,
13028 Collection Center Drive
Chicago,IL60693 		Housekeeping Service 14,148,238
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet174
Form 990 (2019)
Form 990 (2019)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 40,889,560
e Government grants (contributions)1e 54,249,944
f All other contributions, gifts, grants, and similar amounts not included above1f 7,172,283
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f.......MediumBullet 102,311,787
Program Service RevenueAmt Business Code
2a PATIENT SERVICE REVENUE 622110 1,327,113,513 1,327,113,513    
b PHARMACY 446110 20,033,680 19,470,697 562,983  
c ALL OTHER PROGRAM SERVICE REVENUE 900099 18,664,798 18,664,798    
d INCOME FROM EQUITY INVESTEES 523000 12,620,074 13,800,263 -1,180,189  
e OUTREACH LAB 621500 6,229,964 3,347,748 2,882,216  
f All other program service revenue. 634,901 634,901    
g Total. Add lines 2a–2f .....MediumBullet 1,385,296,930
OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 8,967,390   241,562 8,725,828
4 Income from investment of tax-exempt bond proceedsMediumBullet 2,760,561     2,760,561
5 Royalties...........MediumBullet 0      
(ii) Personal (i) Real
6a Gross rents   17,535,615 6a
b Less: rental expenses   883,340 6b
c Rental income or (loss) 0 16,652,275 6c
d Net rental income or (loss).......MediumBullet 16,652,275 16,652,275    
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 588,711 60,446,804 7a
b Less: cost or other basis and sales expenses 623,445 43,802,178 7b
c Gain or (loss) -34,734 16,644,626 7c
d Net gain or (loss).........MediumBullet 16,609,892     16,609,892
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a 0
b Less: direct expenses ... 8b 0
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a 0
b Less: direct expenses ... 9b 0
c Net income or (loss) from gaming activities..MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances ..
10a 0
b Less: cost of goods sold .. 10b 0
c Net income or (loss) from sales of inventory..MediumBullet 0      
Business Code Miscellaneous Revenue
11a            
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 0
12 Total revenue. See instructions.....MediumBullet 1,532,598,835 1,399,684,195 2,506,572 28,096,281
Form 990 (2019)
Form 990 (2019)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 6,245,620 6,245,620
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ........... 0  
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. ............. 12,000 12,000
4 Benefits paid to or for members ....... 0  
5 Compensation of current officers, directors, trustees, and key employees ........... 3,161,351 2,921,440 239,911  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ......... 0      
7 Other salaries and wages........ 457,807,880 423,065,396 34,742,484  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 33,123,437 30,301,814 2,821,623  
9 Other employee benefits ....... 38,891,961 35,594,572 3,297,389  
10 Payroll taxes ........... 29,150,342 26,667,167 2,483,175  
11 Fees for services (non-employees):        
a Management ...... 217,524,827 117,330,498 100,194,329  
b Legal ......... 1,328,827 1,030,482 298,345  
c Accounting ........... -27,104 -21,019 -6,085  
d Lobbying ........... 0      
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 2,057,553   2,057,553  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 98,127,608 49,281,481 48,846,127  
12 Advertising and promotion .... 1,368,312 500,409 867,903  
13 Office expenses ....... 94,545,565 43,796,613 50,748,952  
14 Information technology ...... 2,132,476 779,874 1,352,602  
15 Royalties .. 0      
16 Occupancy ........... 28,782,690 18,698,395 10,084,295  
17 Travel ............ 1,102,999 403,381 699,618  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials . 0      
19 Conferences, conventions, and meetings .... 531,544 194,392 337,152  
20 Interest ........... 20,956,657 617,940 20,338,717  
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization .. 54,099,812 8,417,168 45,682,644  
23 Insurance ... 13,733,012 5,393,002 8,340,010  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a Decrease in Accrued Pension 48,059,094 43,431,333 4,627,761 0
b Medical Supplies Expense 256,211,623 231,540,199 24,671,424  
c EQUIPMENT & MAINTENANCE 11,724,433 10,595,450 1,128,983  
d OUTREACH LAB 42,412,890 38,328,819 4,084,071  
e All other expenses 21,050,908 19,023,849 2,027,059  
25 Total functional expenses. Add lines 1 through 24e 1,484,116,317 1,114,150,275 369,966,042 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2019)
Form 990 (2019)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 114,754,865 1 347,201,457
2 Savings and temporary cash investments ......... 60,333,949 2 29,285,193
3 Pledges and grants receivable, net ...... 0 3 902,072
4 Accounts receivable, net ............. 141,905,797 4 206,176,864
5 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
0 6 0
7 Notes and loans receivable, net ........... 552,654 7 1,086,957
8 Inventories for sale or use ............ 18,917,312 8 23,243,196
9 Prepaid expenses and deferred charges ...... 6,806,008 9 8,686,277
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 1,437,949,042
b Less: accumulated depreciation 10b 581,663,178 815,917,351 10c 856,285,864
11 Investments—publicly traded securities . 1,437,974 11 1,789,737
12 Investments—other securities. See Part IV, line 11 ..... 799,214,880 12 833,658,832
13 Investments—program-related. See Part IV, line 11 .. 46,521,263 13 48,386,446
14 Intangible assets ............... 31,696,686 14 31,696,686
15 Other assets. See Part IV, line 11 ........... 131,473,044 15 53,420,432
16 Total assets. Add lines 1 through 15 (must equal line 33)... 2,169,531,783 16 2,441,820,013
Liabilities 17 Accounts payable and accrued expenses ..... 183,555,821 17 190,341,304
18 Grants payable ... 0 18 0
19 Deferred revenue ......... 0 19 97,932,649
20 Tax-exempt bond liabilities ......... 441,371,631 20 500,474,727
21 Escrow or custodial account liability. Complete Part IV of Schedule D 0 21 0
22 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 0 23 0
24 Unsecured notes and loans payable to unrelated third parties .. 43,874,201 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D 367,809,509 25 516,866,643
26 Total liabilities. Add lines 17 through 25.. 1,036,611,162 26 1,305,615,323
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 1,081,930,171 27 1,127,188,435
28 Net assets with donor restrictions ........... 50,990,450 28 9,016,255
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... 1,132,920,621 32 1,136,204,690
33 Total liabilities and net assets/fund balances ........ 2,169,531,783 33 2,441,820,013
Form 990 (2019)
Form 990 (2019)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
1,532,598,835
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
1,484,116,317
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
48,482,518
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
1,132,920,621
5
Net unrealized gains (losses) on investments ...............
5
-18,302,649
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
-148,956
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-26,746,844
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
1,136,204,690
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2019)
Form 990 (2019)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
Our Lady of the Lake Hospital Inc
 
Employer identification number

72-0423651
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)
1
2
3
4
5
6
7
8
9
10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total
 
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..  
6 Public support. Subtract line 5 from line 4.  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..            
11 Total support. Add lines 7 through 10  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose            
3 Gross receipts from activities that are not an unrelated trade or business under section 513 .....            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge            
6 Total. Add lines 1 through 5            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support. (Subtract line 7c from line 6.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    
Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors
(explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by .035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    
Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 7
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)
Section D - Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity		  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations  
4 Amounts paid to acquire exempt-use assets  
5 Qualified set-aside amounts (prior IRS approval required)  
6 Other distributions (describe in Part VI). See instructions  
7Total annual distributions. Add lines 1 through 6.  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI). See instructions		  
9 Distributable amount for 2019 from Section C, line 6  
10 Line 8 amount divided by Line 9 amount  
Section E - Distribution Allocations (see instructions) (i)
Excess Distributions 		(ii)
Underdistributions
Pre-2019 		(iii)
Distributable
Amount for 2019
1 Distributable amount for 2019 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI).
See instructions.		  
3 Excess distributions carryover, if any, to 2019:
a From 2014.......  
b From 2015.......  
c From 2016.......  
d From 2017.......  
e From 2018.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2019 distributable amount  
i Carryover from 2014 not applied (see
instructions) 		 
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2019 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2019 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2019, if any. Subtract lines 3g and 4a from line 2.
If the amount is greater than zero, explain in Part VI.
See instructions.		  
6 Remaining underdistributions for 2019. Subtract
lines 3h and 4b from line 1. If the amount is greater
than zero, explain in Part VI. See instructions.		  
7 Excess distributions carryover to 2020. Add lines
3j and 4c.		  
8 Breakdown of line 7:
a Excess from 2015.....  
b Excess from 2016.....  
c Excess from 2017.....  
d Excess from 2018.....  
e Excess from 2019.....  
Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
Schedule A (Form 990 or 990-EZ) 2019


Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Name of the organization
Our Lady of the Lake Hospital Inc
 
Employer identification number

72-0423651
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ






Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2
Name of organization
Our Lady of the Lake Hospital Inc
  		Employer identification number
72-0423651
Part I
Contributors
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
 
 
 
 
  ,    

$ RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Page 3
Name of organization
Our Lady of the Lake Hospital Inc
  		Employer identification number

72-0423651
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a)
No. from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Page 4
Name of organization
Our Lady of the Lake Hospital Inc
  		Employer identification number

72-0423651
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Additional Data


Software ID:  
Software Version:  
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
SchDMd Bullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
Our Lady of the Lake Hospital Inc
 
Employer identification number

72-0423651
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included on Form 990, Part VIII, line 1 .........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2019

Schedule D (Form 990) 2019
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c  
d Additions during the year ............................ 1d  
e Distributions during the year .......................... 1e  
f Ending balance ................................ 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....
Part V
Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.
(a) Current year (b) Prior year (c) Two years back (d) Three years back (e) Four years back
1a Beginning of year balance ....          
b Contributions ...          
c Net investment earnings, gains, and losses          
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ... 		         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Term endowment SchDMd Bullet  
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .................
3a(i)
 
 
(ii) Related organizations .................
3a(ii)
 
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis
(investment) 		(b) Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .....   83,159,133 83,159,133
b Buildings ....   926,253,296 323,030,344 603,222,952
c Leasehold improvements   3,517,907 1,535,838 1,982,069
d Equipment ....   402,705,216 241,199,073 161,506,143
e Other .....   22,313,490 15,897,923 6,415,567
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 856,285,864
Schedule D (Form 990) 2019

Schedule D (Form 990) 2019
Page 3
Part VII
Investments—Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1) Financial derivatives.........    
(2) Closely-held equity interests........    
(3) Other
(A) INVESTMENT IN CAPITAL RESERVE		 833,432,904 F

(B) INVESTMENT IN REGIONAL EYE		 225,928 F
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 833,658,832
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes 0
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 516,866,643
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2019

Schedule D (Form 990) 2019
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1.................. 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b.................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities ......... 2a  
b Prior year adjustments ............ 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d.................... 2e  
3 Subtract line 2e from line 1................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b..................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
FIN 48 (ASC 740 FOOTNOTE) Schedule D The Medical Center recognizes the effect of income tax positions only if those positions are more likely than not of being sustained. Recognized income tax positions are measured at the largest amount that is greater than 50% likely of being realized. Changes in recognition or measurement are reflected in the period in which the change in judgment occurs. No reserves for uncertain tax positions have been recorded.
Schedule D (Form 990) 2019


Additional Data


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SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990.Right pointing arrow large image Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
Our Lady of the Lake Hospital Inc
 
Employer identification number

72-0423651
Part I
General Information on Activities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of its grants and
other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used
to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in the region (d) Activities conducted in region (by type) (such as, fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in the region		 (f) Total expenditures
for and investments
in the region
Central America and the Caribbean     Grantmaking GENERAL SUPPORT 12,000
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total ....     12,000
b Total from continuation sheets to Part I ...      
c Totals (add lines 3a and 3b)     12,000
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2019
Schedule F (Form 990) 2019
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)		 (c) Region (d) Purpose of
grant 		(e) Amount of
cash grant 		(f) Manner of
cash
disbursement 		(g) Amount
of noncash
assistance 		(h) Description
of noncash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
Central America and the Caribbean GENERAL SUPPORT 12,000 CHECK      
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......MediumBullet
1
3 Enter total number of other organizations or entities .......................MediumBullet
 
Schedule F (Form 990) 2019
Schedule F (Form 990) 2019Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 16.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant 		(e) Manner of cash
disbursement 		(f) Amount of
noncash
assistance 		(g) Description
of noncash
assistance 		(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2019
Schedule F (Form 990) 2019
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .
Schedule F (Form 990) 2019
Schedule F (Form 990) 2019
Page 5
Part V
Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information. See instructions.
ReturnReference Explanation
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2019
Additional Data


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SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
Our Lady of the Lake Hospital Inc
 
Employer identification number

72-0423651
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
 
No
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . . 		    27,289,146 23,614,152 3,674,994 0.250 %
b Medicaid (from Worksheet 3, column a) . . . . .     329,669,425 257,200,806 72,468,619 5.010 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .     356,958,571 280,814,958 76,143,613 5.260 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     2,923,970 239,276 2,684,694 0.190 %
f Health professions education (from Worksheet 5) . . .     47,545,798 21,173,063 26,372,735 1.820 %
g Subsidized health services (from Worksheet 6) . . . .     4,711,308 731,178 3,980,130 0.280 %
h Research (from Worksheet 7) .     3,255,478 2,066,527 1,188,951 0.080 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     960,087   960,087 0.070 %
j Total. Other Benefits . .     59,396,641 24,210,044 35,186,597 2.440 %
k Total. Add lines 7d and 7j .     416,355,212 305,025,002 111,330,210 7.700 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support     160,866 559 160,307 0.010 %
4 Environmental improvements            
5 Leadership development and
training for community members		            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total     160,866 559 160,307 0.010 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
155,580,149
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
173,734,122
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
181,263,537
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-7,529,415
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1SURGICAL SPECIALTY
  		SURGERY CENTER 49 %   51 %
2REGIONAL EYE SURGERY
  		IMAGING SERVICES 10.75 %   89.25 %
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?3Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 OUR LADY OF THE LAKE HOSPITAL
4200 ESSEN ALNE
BATON ROUGE,LA70809
WWW.OLOLRMC.COM 		X X   X     X      
2 SURGICAL SPECIALTY CTR OF BATON ROUGE
8080 BLUEBONNET BLVD
BATON ROUGE,LA70810
WWW.SSCBR.COM 		X X                
3 LAKE SURGICAL HOSPITAL (SLIDELL) LLC
1700 LINDBERG DR
SLIDELL,LA70458
WWW.SSHLA.COM 		X X                
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
OUR LADY OF THE LAKE HOSPITAL
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 18
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10   No
a If "Yes" (list url):  
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b Yes  
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
OUR LADY OF THE LAKE HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SUPPLEMENT AT PART V
b
SEE SUPPLEMENT AT PART V
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
OUR LADY OF THE LAKE HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
OUR LADY OF THE LAKE HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
SURGICAL SPECIALTY CTR OF BATON ROUGE
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		2
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 18
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10   No
a If "Yes" (list url):  
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b Yes  
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
SURGICAL SPECIALTY CTR OF BATON ROUGE
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SUPPLEMENT AT PART V
b
SEE SUPPLEMENT AT PART V
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
SURGICAL SPECIALTY CTR OF BATON ROUGE
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
SURGICAL SPECIALTY CTR OF BATON ROUGE
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Lake Surgical Hospital (Slidell) LLC
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		3
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 20
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 20
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10   No
a If "Yes" (list url):  
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b Yes  
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Lake Surgical Hospital (Slidell) LLC
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SUPPLEMENT AT PART V
b
SEE SUPPLEMENT AT PART V
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
Lake Surgical Hospital (Slidell) LLC
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Lake Surgical Hospital (Slidell) LLC
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 8
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
PART V, SECTION B, QUESTION 13H OUR LADY OF THE LAKE HOSPITAL: PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE: 1. THE PATIENT RECEIVING FREE CARE FROM A COMMUNITY CLINIC AND IS REFERRED TO THE HOSPITAL; 2. STATE-FUNDED PRESCRIPTION PROGRAMS; 3. HOMELESS, INDIGENT, OR HOMELESS CLINIC PATIENT; 4. PATIENTS' CHILDREN WHO QUALIFY FOR OTHER FINANCIAL ASSISTANCE PROGRAMS; 5. PATIENT ELIGIBLE FOR FOOD STAMPS; 6. MEDICAID ELIGIBLE PATIENT; 7. PATIENT IS DECEASED WITH NO KNOWN RESPONSIBLE PARTY; 8. PATIENT IS INCARCERATED AND HAS NO OTHER RESPONSIBLE PARTY
PART V, SECTION B, QUESTION 5 OUR LADY OF THE LAKE HOSPITAL (OLOL) AND SURGICAL SPECIALTY CENTER (SSC)OF BATON ROUGE: OLOL & SSC JOINED THE MAYOR'S HEALTHY CITY INITIATIVE AND SITS AMONG OTHER LOCAL AREA HOSPITALS IN AN OPEN COLLABORATIVE EFFORT TO IMPROVE THE HEALTH OF THE BATON ROUGE COMMUNITY. THE MAYOR'S HEALTHY CITY INITIATIVE WORKED WITH HEALTHY BR AND MEDBR TO COMPLETE THE COMMUNITY NEEDS ASSESSMENT. AMONG THESE GROUPS, THERE WERE REPRESENTATIVES FROM NUMEROUS BUSINESSES, HOSPITALS, GOVERNMENT ORGANIZATIONS INCLUDING THE OFFICE OF PUBLIC HEALTH, NONPROFIT ORGANIZATIONS AND SCHOOLS.THE LOCAL HOSPITALS PARTICIPATING WERE WOMAN'S HOSPITAL, BATON ROUGE GENERAL MEDICAL CENTER, OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER, LANE REGIONAL MEDICAL CENTER, SURGICAL SPECIALTY CENTER OF BATON ROUGE, AND OCHSNER MEDICAL CENTER BATON ROUGE. LAKE SURGICAL HOSPITAL: LAKE SURGICAL HOSPITAL (SLIDELL) GATHERED INFORMATION FOR ITS CHNA USING SURVEYS, INTERVIEWS, AND PUBLISHED MATERIALS. THE HOSPITAL INTERVIEWED LEADERS FROM ORGANIZATIONS THAT INCLUDED PROFESSIONALS WITH ACCESS TO COMMUNITY HEALTH RELATED DATA, AND REPRESENTATIVES OF UNDERSERVED POPULATIONS INCLUDING ADMINISTRATIVE LEADERSHIP IN LOW INCOME AND UNDERSERVED AREAS. LEADERS FROM THE COUNCIL ON AGING, THE CENTERS OF DISEASE AND CONTROL, CENTERS FOR MEDICARE AND MEDICAID SERVICES, AND THE PARISH HEALTH AUTHORITIES PROVIDED INPUT AND GUIDANCE ON THE CHNA.
PART V, SECTION B, QUESTION 6 OUR LADY OF THE LAKE HOSPITAL AND SURGICAL SPECIALTY CENTER: A JOINT CHNA WAS CONDUCTED IN COLLABORATION WITH WOMAN'S HOSPITAL, BATON ROUGE GENERAL MEDICAL CENTER AND LANE REGIONAL MEDICAL CENTER THROUGH THE MAYOR'S HEALTHY CITY INITIATIVE.
PART V, SECTION B, QUESTION 7 OUR LADY OF THE LAKE HOSPITAL AND SURGICAL SPECIALTY CENTER: THE JOINT CHNA CAN BE FOUND AT THE FOLLOWING WEBSITES: HTTPS://OLOLRMC.COM/PAGES/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.ASPX http://www.healthybr.com/be-smart/community-health-needs-assessment HTTP://WWW.SSCBR.COM/
PART V, SECTION B, QUESTION 11 Our Lady of the Lake, Surgical Specialty Center and Our Lady of the Lake Surgical Hospital: In 2018 the participants of the joint CHNA identified four significant health needs in our community. OLOL focuses on all four significant needs identified: HIV/Sexually Transmitted Infections, Healthy Living, Access to Care, and Behavioral and Mental Health. OLOL has contributed the following to address these needs during the FYE 2020: Mental and Behavioral Health: OLOL worked to increase the percentage of compliance with depression screenings performed by LPG on individuals over 12 years of age and during this time period averaged a 43% completion rate. OLOL partnered with the Ascension Counseling Center referring patients for counseling - ACC served 4566 patients during this time frame. We planned for the opportunity to provide medical assistance detox (MAT) at the Family Center at O'Donovan, completed MD and nursing education and the compliance for the EPIC build - this went live in FYE 21. Continued to offer four clinic sites providing collaborative care, a $300K investment from OLOL. Continued to run a psychology intern program at the set up cost of $498K; as well as a psychiatry residency program with an investment of $175K. Worked towards increasing awareness and safe practice around prescribing, dispensing, and disposing of controlled substances. The DA funded 4 positions in OLOL Emergency Room for the implementation of the healthcare antiviolence intervention program. OLOL presented the Gabby Bessix antiviolence lecture series three times. HCCS provided 4674 encounters offering risk assessments, depression screenings, individual counseling and group counseling. HIV/Sexually Transmitted Infections: HCCS provided 2,712 STD Screenings along with prevention education to students. Provided HIV testing in OLOL Emergency Rooms and LSUHBR Clinics: In 2019 we had tested 29,828 with a 22% testing rate across all five sites; from January to June 2020 we tested 12,339 patients with a testing rate of 23% and Added two certified testing counselors in clinic settings. We linked 83% of newly diagnosed patients to care and Added a substance abuse therapy program for our patients. We hosted seven community events between Jan 2019 and June 2020 completing 252 tests. We began planning for Opt out Hep C testing to begin in FYE 2021. We were Active participants in the Mayor's Ending the HIV Epidemic Campaign. Healthy Living: We began planning for the Geaux Get Healthy program in conjunction with other community partners -community participants will be screened for food insecurity and then referred into a nutrition class, cooking classes, and a grocery store tour. OLOL Physicians began using the SSDH survey and made referrals into the GGH program. We continue to offer a Smoking Cessation program with one full time NCCTP and one CTTP and one part time PA. We have treated 840 new patients and have a current patient caseload of 201 active patients. We provide services in Baton Rouge, Gonzales, Lake Livingston, and New Roads. We sponsored BREADA for $20K to ensure healthy foods were accessible in targeted zip codes. Although limited by COVID, community education continued on 5210+10 (a childhood obesity prevention message). We also sponsored community education regarding chronic disease prevention and management and the introduction of COVID prevention education. Additional Outreach included: Partnership with Mary Bird Perkins to offer cancer screenings in both EBR and Ascension Parishes, health education on Obesity, Diabetes and Arthritis (although severely redistricted by COVID). 219 women were provided biometric screening by OLOL at Pennington's Women's Wellness Day sponsored by OLOL. 24 patients completed OLOL's Diabetes management Program.* 180 OLOL Ascension team members engaged in health coaching afforded to them for free by our OLOL's Healthy Lives Program (40 completed coaching program during this time frame). *Diabetes Management Program suspended between April and June Access to Care: OLOL continued to work toward increasing Medicaid enrollments assisted by OLOL staff - averaging an 85% conversation rate of applied to enrolled. This factors in increases due to loss of employment and changes in Medicaid guidelines; and decreases attributed to covid's effect on employment rates, missed appointments and access to patients. HCCS provided services to seven EBR Parish Schools, nine Charter Schools - at total of 45,241 students. Care included 4440 well checks, 3344 nursing encounters for injections, immunizations and labs and 3838 encounters for chronic disease care. OLOL invested $150K to expand the Faith Fund into communities of need; this fund provides low interest loans as an alternative to Pay Day lenders. OLOL North Clinic began surveying patients for Social Determinants of Health (SDOH) and when a patient is found to have food insecurity they are referred to the Geaux Get Healthy Program (see Healthy Living). OLOL's physicians have continued to lend expertise to projects related to access to care and have actively begun participating in collaborations with other community based organizations. The work during this time period has been focused on building out the tools that will be used by providers to address SDOH. Additionally they have begun to work on changing the culture to one that will consider SDOH in patient treatment. Surgical Specialty Center: Surgical Specialty Center addressed the significant community health needs identified in the joint Community Health Needs Assessment along with OLOL. SSC provides services to those with Medicaid coverage and provides charity care. The Ear, Nose and Throat doctors at SSC are the only ENT Doctors in East Baton Rouge Parish who accept Medicaid. They are sent referrals for areas outside of the East Baton Rouge Parish as well. Our Lady of the Lake Surgical Hospital: Our Lady of the Lake Surgical Hospital addressed the following three identified health needs: Obesity, Access to health services, and specific orthopedic service line access. OBESITY Our Lady of the Lake Surgical Hospital provides nutritional information to older adults and senior citizens through quarterly presentations by hospital dietitians. Prior to COVID-19 restrictions, the dietitians travelled to Council on Aging St. Tammany (COAST) facilities for presentations. Times are allotted to offer free consultations monthly with a dietitian at the facility as requested. Our Lady of the Lake Surgical Hospital provides dietetic resources through 2 FTEs who provide consultation to nearly 700 patients annually. The dietitians provide services to approximately 15 patients per week. Of the approximately 700 patients seen annually, approximately 100 take advantage of follow-up nutritional support. Our Lady of the Lake Surgical Hospital provides online support for obese individuals in the community during the pandemic. Nutritional support is also offered to these individuals via an online resource, Bariatric Support Center International, which may better meet their needs. ACCESS TO HEALTH SERVICES Our Lady of the Lake Surgical Hospital provides print advertisement discussing available healthcare services provided at the facility. There were 12 ads placed providing information to the community along with 2 radio advertisements. OLOL also provides a directory of physicians and services available at the facility and within the community. This information is available through printed brochures, newspaper, and website distribution. SPECIFIC ORTHOPEDIC SERVICES LINE ACCESS The hospital provides services to the community in both an inpatient and outpatient capacity. The hospital provides 1 FTE to ensure adequate support and the ability to provide information regarding services available in the hospital or to the community in general. Our Lady of the Lake Surgical Hospital supports a case management, social services, and discharge planning program. Social Services has access to community services such as AA, multiple drug education programs, and other resources available through St. Tammany Parish. The facility offers education regarding smoking cessation, nutrition, and surgical and healthcare services, and continues to maintain a website and resources committed to offering support to the community.
PART V, SECTION B, QUESTION 16A, B, & C OUR LADY OF THE LAKE HOSPITAL: THE FINANCIAL ASSISTANCE POLICY (FAP), FAP APPLICATION FORM, AND A PLAIN-LANGUAGE SUMMARY OF THE FAP ARE AVAILABLE AT: https://fmolhs.org/financial-assistance-policy/ SURGICAL SPECIALTY CENTER OF BATON ROUGE: THE FINANCIAL ASSISTANCE POLICY (FAP), FAP APPLICATION FORM, AND A PLAIN-LANGUAGE SUMMARY OF THE FAP ARE AVAILABLE AT: HTTP://WWW.SSCBR.COM/PAGE.PHP?PID=21 LAKE SURGICAL HOSPITAL (SLIDELL): THE FINANCIAL ASSISTANCE POLICY (FAP), FAP APPLICATION FORM, AND A PLAIN-LANGUAGE SUMMARY OF THE FAP ARE AVAILABLE AT: HTTP://OLOLSH.COM/FOR-PATIENTS/
PART V, SECTION B, QUESTION 16J OUR LADY OF THE LAKE HOSPITAL, SURGICAL SPECIALTY CENTER OF BATON ROUGE, LAKE SURGICAL HOSPITAL (SLIDELL):REGISTRATION PERSONNEL REFER UNINSURED AND/OR LOW-INCOME PATIENTS TO FINANCIAL COUNSELORS TO DISCUSS THE FINANCIAL ASSISTANCE POLICY.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 9
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?6
Name and address Type of Facility (describe)
1 PERKINS PLAZA AMB SURGERY CENTER
7145 PERKINS ROAD
BATON ROUGE,LA708084322 		SURGERY CENTER
2 CONVENIENT CARE LLC
7777 HENNESSY BOULEVARD
BATON ROUGE,LA70808 		URGENT CARE
3 BRPT-LAKE REHABILITATION CENTERS LLC
530 SHADOWS LANE
BATON ROUGE,LA70806 		REHABILITATION
4 LAKE URGENT CARE ASCENSION LLC
10319 JEFFERSON HIGHWAY
BATON ROUGE,LA70809 		URGENT CARE
5 OLOL PONTCHARTRAIN SURGERY CENTER LLC
15305 DALLAS PKWY STE 1600 LB 28
ADDISON,TX75001 		SURGERY CENTER
6 PINNACLE CARE HOLDINGS LLC
5627 S SHERWOOD FOREST BLVD
BATON ROUGE,LA70816 		HOME HEALTH
7
8
9
10
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 10
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
PART I, LINE 7: As part of its mission to improve the lives and health of community members, OLOL has a cooperative endeavor agreement (CEA) with the State of Louisiana Department of Health, formerly known as DHH, and Louisiana State University Health Sciences (LSU) that trains future physicians for our area and provides healthcare access to uninsured and under-insured residents. This public-private partnership has enabled positive healthcare transformation in Baton Rouge. Despite the closing of state-run hospitals and clinics, including Earl K. Long Medical Center in April 2013, and added challenges to the healthcare system created by the Baton Rouge General's closure of its Mid-City Emergency Room (ER) in March 2015, recent data shows that this new model of care in Baton Rouge is working well. The benefits of the CEA to the community are visible in the following ways: Patient Care A. Uninsured and Medicaid patients have access to more than 20 specialty services, many of which were not available to prior to the CEA. Local services now provided oncology, mental health/psych, mental health integration into primary care with the availability of a psychiatrist as a consultant, treatment of Hepatitis C with the help of a Hepatologist as a consultant, diabetes care, dermatology, cardiology and more, along with pharmacy, imaging and diagnostic services. With the 2016 Medicaid expansion in Louisiana, we have seen an increase across the board in clinic visits, up from 160,439 in 2017 to 161,541 in 2018. Those outpatient visits have more than doubled from 2012 due to expanded insurance coverage and more opportunity to access care. Increased access to care also included access to pharmacy and urgent care services. Patients filled 116,508 prescriptions that helped treat both acute and chronic conditions such as hypertension, asthma, diabetes and HIV. B. In coordination with LSU Health, OLOL operates two urgent care clinics to cost-effectively treat a wide range of injuries and conditions including infections, flus and fevers, broken bones and minor burns. Patients with these conditions would typically seek treatment in EDs which carry increased costs. Uninsured and an increasing number of patients with Medicaid, now have access to a more abundant right place, right level of care for these healthcare needs through LSU Health Urgent Care Centers and Lake After Hours. LSU Health has encountered 56,099 patients via its two Urgent Care locations. C. Increasing capacity for Emergency care has also been a priority for OLOL, especially in light of being the only Emergency Department in a 20 mile radius of North Baton Rouge and Mid City. Through the CEA with support from the state of Louisiana, OLOL made the decision to expand access and open a stand-alone Emergency Department on the campus of LSU Health North Baton Rouge clinic and urgent care site. By being in such close proximity to the Urgent Care vs the ED, this care coordination allows for opportunities to educate patients on the appropriate use of the emergency department as well as allows those who truly are in need of emergent care to receive treatment in a timely manner. D. Our Lady of the Lake is the only designated trauma center in region 2, which cared for 3,427 patients in 2018. 9.1% of all trauma patients were uninsured in 2018 and 36.3% had Medicaid as their payment source. The trend of half of all trauma patients treated each year being uninsured or having Medicaid has been consistent since 2012. Graduate Medical Education A. Through the CEA, OLOL is training future generations of physicians in nearly all medical specialties and subspecialties as these clinicians commit to improve patient care in Baton Rouge. Equally important, academic medical centers such as OLOL are attracting the top physicians in the country, which helps advance medicine and deliver more comprehensive services in Baton Rouge, the surrounding parishes and the state. B. OLOL serves as a clinical teaching site for 26 residency and fellowship programs, including 19 through Louisiana State University Health Sciences Center, OLOL (2), Baton Rouge General (3), and a joint program between OLOL and LSU (1).In addition to these improvements in the quality of care for uninsured and Medicaid patients in the area, OLOL has made capital investments that have benefitted families in the community and the region, including: 1. Building of Children's Hospital starting in 2016 and opening in Fall 2019 2. Opening of new North BR Emergency Room. Through this innovative partnership, OLOL has increased its efforts and reaffirmed its focus to bring better, more accessible care to the residents of Baton Rouge, and the organization remains devoted to serving the health needs of this community well into the future. Louisiana Department of Health provides payments under a reimbursement structure which are intended to compensate the hospital for incremental costs associated with higher Medicaid and uninsured patient volumes. Because of these reimbursements, which are considered direct offsetting revenue, the hospital's vital impact to the community in this effort is not directly reflected in the net community benefit percentage found at line 7k, column (f). The significant benefit to the community is better expressed as a percentage of total community benefit expense.
PART I, LINE 7: THE COST-TO-CHARGE RATIO IS UTILIZED AS THE COSTING METHODOLOGY TO CALCULATE THE AMOUNTS REPORTED IN PART I LINES 7A-7D AND IS BASED ON THE COST ACCOUNTING SYSTEM OF THE ORGANIZATION. FOR PART I LINES 7E, 7F, 7H AND 7I, DIRECT COSTS WERE CAPTURED FROM THE HOSPITAL'S AUDITED FINANCIAL STATEMENTS AND THE MEDICARE COST REPORT WHERE APPLICABLE. FOR PART I LINE 7G, COST FIGURES WERE CALCULATED FROM DEPARTMENTAL COSTS LESS DIRECT OFFSETTING REVENUE.
PART III, LINE 4: THE BAD DEBT FOOTNOTE IS ON PAGE 18 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS.
PART III, LINE 8: THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE MEDICARE COST REPORT IS BASED ON REGULATORY REQUIREMENTS AND GUIDELINES.
PART III, LINE 9B: PATIENTS WITH NO MEANS OF PAYMENT MAY APPLY FOR FINANCIAL ASSISTANCE. APPROVAL WILL BE BASED ON INCOME, ASSETS, AND MEDICAL EXPENSES AS SET FORTH IN THE FINANCIAL ASSISTANCE POLICY. ACCOUNTS MAY ALSO BE FULLY DISCOUNTED BASED ON A PRESUMPTIVE CHARITY SCORING SYSTEM WHICH IS SIMILAR TO CREDIT SCORING. TO THE EXTENT APPROPRIATE AND PERMITTED BY LAW, FINANCIAL COUNSELING AND SCREENINGS ARE CONDUCTED AT THE TIME OF ENCOUNTER TO ASSIST IN IDENTIFYING PATIENTS WHO WOULD LIKELY QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S POLICY. THESE PROCESSES HELP IDENTIFY (EARLY IN THE PROCESS) PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE. THIS HELPS KEEP QUALIFYING PATIENTS OUT OF THE HOSPITAL'S COLLECTION PROCESSES BECAUSE AMOUNTS COVERED BY FINANCIAL ASSISTANCE ARE NOT SUBJECT TO THE HOSPITAL'S COLLECTION PRACTICES. HOWEVER, IF IT IS DETERMINED THAT A PATIENT QUALIFIES FOR CHARITY CARE AFTER THE INDIVIDUAL'S ACCOUNT HAS BEEN SENT TO COLLECTIONS, THE AMOUNT IS IMMEDIATELY REMOVED FROM THE COLLECTIONS PROCESS.
PART VI, LINE 2: NEEDS ASSESSMENT: RESPONDING TO THE HEALTH NEEDS OF OUR COMMUNITY, ESPECIALLY TO THOSE MOST IN NEED, IS PRIMARY TO THE HOSPITAL'S MISSION. AS SUCH, OUR LADY OF THE LAKE HOSPITAL JOINED the Mayor's Healthy City Initiative in 2007. Still today, OLOL sits among other local area hospitals in an open collaborative effort to improve the health of the Baton Rouge community. The Community Health Needs Assessment is just one of many joint efforts that OLOL has participated in alongside other hospitals and organizations. In May of 2008, Baton Rouge Mayor-President Melvin L. "Kip" Holden commissioned the Mayor's Healthy City Initiative to encourage Baton Rouge residents to adopt a healthier and more active lifestyle. In 2017 there was a change in administration, and the new mayor; Sharon Weston Broom committed to and continues the work of the Mayor's Healthy City Initiative. Both Mayors envision a program that would promote and identify resources available in the community for residents to live healthier lives free of chronic disease. In Louisiana, almost half of our children are considered overweight or obese, putting them at a much greater risk of obesity-related health problems like diabetes, heart disease, stroke, cancer and asthma. Nationwide the number of children who are considered overweight or obese has nearly tripled over the past 30 years. To tackle this problem, the Mayor subdivided the Initiative into 2 separate but compatible parts: Healthy BR - a focus on healthier eating and a more active lifestyle MedBR - a focus on access to care and health outcomes Each subgroup engages a variety of partner organizations in a cooperative effort between local and state governments, area hospitals, public health, and local health organizations and nonprofits. OLOL is a major supporter and contributor of the Mayor's Healthy City Initiative. the Mayor's Healthy City Initiative served as a common platform, allowing for in-depth roundtable discussions among local area hospitals. The OLOL Community Advocacy team facilitated those discussions and processes for completing the CHNA report. OLOL ALSO WORKS SEPARATELY WITH COMMUNITY ORGANIZATIONS (on the CHNA Implementation Plan) SUCH AS UNITED WAY, PUBLIC HEALTH, AMERICAN HEART ASSOCIATION, BREC, BRAC, AND MANY OTHER ORGANIZATIONS TO DEFINE COMMUNITY NEEDS AND TO CONSOLIDATE EFFORTS TO MEET THOSE COMMUNITY NEEDS. FOR EXAMPLE, PARISH NURSING, HEALTH SCREENING FOR DIABETES, SKIN CANCER, PROSTATE CANCER AND BREAST CANCER ARE PROMOTED IN VARIOUS COMMUNITY SETTINGS TO IMPROVE OVERALL COMMUNITY HEALTH. OLOL HAS PARTNERSHIPS WITH COMMUNITY ORGANIZATIONS THAT ADDRESS THE 4 SIGNIFICANT HEALTH NEEDS THAT WERE IDENTIFIED IN THE CHNA.
PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: INDIVIDUALS ARE EDUCATED ABOUT ELIGIBILITY FOR ASSISTANCE UNDER GOVERNMENT PROGRAMS AND THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY AT VARIOUS STAGES OF THE ENCOUNTER WITH OUR LADY OF THE LAKE HOSPITAL. PATIENTS ARE INFORMED THROUGH A PATIENT HANDBOOK THAT CONTAINS INFORMATION ON THE FINANCIAL POLICIES OF THE HOSPITAL. ADDITIONALLY, SYSTEMS AND TOOLS ARE UTILIZED TO CONDUCT HIGH LEVEL FINANCIAL SCREENING TO ASSIST IN IDENTIFYING PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE. WHEN AND WHERE APPROPRIATE, FINANCIAL COUNSELORS VISIT PATIENTS AT THE TIME OF THE ENCOUNTER AND EXPLAIN THE ASSISTANCE OPTIONS AVAILABLE. FINANCIAL COUNSELORS WORK WITH PATIENTS TO ASSIST WITH ENROLLMENT FOR MEDICAID FOR THOSE WHO ARE ELIGIBLE AS WELL AS TO ASSIST THOSE WHO QUALIFY FOR HOSPITAL FINANCIAL ASSISTANCE.
PART VI, LINE 4 COMMUNITY INFORMATION: OUR LADY OF THE LAKE HOSPITAL (OLOL) IS A COMMUNITY-BASED, NOT-FOR-PROFIT HOSPITAL LOCATED IN BATON ROUGE, LOUISIANA THAT SERVES EAST BATON ROUGE PARISH AND PORTIONS OF THE SURROUNDING PARISHES. PURSUANT TO THE HOSPITAL'S LAST CHNA, EAST BATON ROUGE HAS A POPULATION OF APPROXIMATELY 445,227 RESIDENTS. THE POPULATION IS RELATIVELY YOUNG, A MEDIAN AGE OF 33. THE SENIOR POPULATION COMPRISES ABOUT 12% OF THE TOTAL POPULATION. THE MEDIAN HOUSEHOLD INCOME IS $49,942. 19.5% OF THE POPULATION IS LIVING BELOW THE POVERTY LEVEL AND THE UNEMPLOYMENT RATE IS 3.6%.
PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: OUR LADY OF THE LAKE HOSPITAL PARTICIPATES IN COMMUNITY IMPROVEMENT ACTIVITIES BECAUSE IT UNDERSTANDS THAT IMPROVEMENTS TO A COMMUNITY HAVE A DIRECT LINK TO THE IMPROVED HEALTH OF COMMUNITY RESIDENTS. COMMUNITY IMPROVEMENT ACTIVITIES INCLUDE THE FOLLOWING: OUR LADY OF THE LAKE ESTABLISHED CLINICS LOCATED IN AREAS WITHIN UNDER-INSURED/LOW INCOME AREAS. THIS ALLOWS INDIVIDUALS TO ACCESS HEALTH CARE SERVICE THAT WOULD BE FOREGONE OR POSTPONED THEREBY CREATING A COMMUNITY AREA WITH MORE INTENSE HEALTH ISSUES/PROBLEMS. OUR LADY OF THE LAKE PROVIDES OVERSIGHT OF COMMUNITY PROGRAMS AND ACTIVITIES AND COORDINATED HEALTH CARE SCREENING FOR VARIOUS HEALTH ISSUES. OUR LADY OF THE LAKE BECAME A TEACHING HOSPITAL THROUGH AFFILIATION WITH LOUISIANA STATE UNIVERSITY MEDICAL SCHOOL TO INSURE THE STATE OF LOUISIANA MAINTAIN AN ADEQUATE SUPPLY OF PHYSICIANS. IN 2011 OUR LADY OF THE LAKE RECEIVED ACCREDITATION APPROVAL FOR A PEDIATRIC GRADUATE MEDICAL EDUCATION PROGRAM. THE MAJORITY OF THE GOVERNING BODY OF OUR LADY OF THE LAKE IS COMPRISED OF INDIVIDUALS FROM A BROAD CROSS-SECTION OF THE COMMUNITY WHO RESIDE IN THE PRIMARY SERVICE AREA AND WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION. OLOL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY FOR SOME OR ALL OF THE HOSPITAL DEPARTMENTS AS NEEDED. SURPLUS FUNDS ARE APPLIED TO IMPROVEMENTS IN PATIENT CARE AREAS THROUGH INVESTMENT IN CLINICAL TECHNOLOGY, MEDICAL INFORMATION TECHNOLOGY, AND CONTINUED TRAINING OF CLINICAL STAFF. FOR MORE INFORMATION ON THE PROMOTION OF COMMUNITY HEALTH, PLEASE REFER TO THE PART VI SUPPLEMENTAL INFORMATION DESCRIPTION FOR PART 1 QUESTION 7.
PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: OUR LADY OF THE LAKE HOSPITAL IS A NOT-FOR-PROFIT HOSPITAL, NON-STOCK, MEMBER CORPORATION OF WHICH FRANCISCIAN MISSIONARIES OF OUR LADY HEALTH SYSTEM, INC. (FMOL HEALTH SYSTEM) IS THE SOLE MEMBER. OUR LADY OF THE LAKE HOSPITAL IS PART OF THE FMOL HEALTH SYSTEM WHICH INCLUDES SEVERAL HOSPITALS AND TAX-EXEMPT AFFILIATES THROUGHOUT THE STATE OF LOUISIANA, AND ONE IN MISSISSIPPI. OUR LADY OF THE LAKE HOSPITAL SERVES THE COMMUNITY IN EAST BATON ROUGE PARISH AND SURROUNDING PARISHES. OTHER RELATED HOSPITALS IN LOUISIANA INCLUDE: OUR LADY OF LOURDES REGIONAL MEDICAL CENTER ST FRANCIS MEDICAL CENTER OUR LADY OF THE LAKE ASSUMPTION HOSPITAL OUR LADY OF THE ANGELS HOSPITAL RELATED HOSPITAL IN MISSISSIPPI: ST. DOMINIC JACKSON MEMORIAL HOSPITAL
PART III, SECTION A, QUESTION 2 THE HOSPITAL ACCOUNTS FOR BAD DEBTS BASED ON THE AGING OF THE ACCOUNTS AND BASED ON THE HISTORICAL COLLECTION ASSOCIATED WITH THE VARIOUS AGING CATEGORIES. ON A PERIODIC BASIS, THE ORGANIZATION CONDUCTS A RETROSPECTIVE REVIEW TO DETERMINE THE APPROPRIATENESS OF THE COLLECTION PERCENTAGES UTILIZED IN ESTIMATED BAD DEBT EXPENSE. CHARITY AND DISCOUNTS ARE NOT INCLUDED IN BAD DEBT EXPENSE. PAYMENTS RECEIVED ON ACCOUNTS SUBSEQUENT TO BEING CONSIDERED BAD DEBT ARE RECORDED AS A REDUCTION OF BAD DEBT EXPENSE.
PART I, LINE 3C FINANCIAL ASSISTANCE IS AVAILABLE FOR INDIVIDUALS WHO ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR ANY GOVERNMENT HEALTH CARE BENEFIT PROGRAM, AND WHO ARE UNABLE TO PAY FOR THEIR CARE. FULLY-DISCOUNTED CARE IS AVAILABLE IF INCOME AND ASSETS MEET CERTAIN FEDERAL POVERTY GUIDELINE LEVELS. FULLY-DISCOUNTED CARE IS ALSO AVAILABLE FOR THOSE PATIENTS WITH CATASTROPHIC MEDICAL BILLS IF MEDICAL BILLS EXCEED A CERTAIN PERCENTAGE OF INCOME AND ASSETS. FULLY DISCOUNTED CARE IS ALSO AVAILABLE WHERE THE PATIENT OR OTHER SOURCES CAN PROVIDE SUFFICIENT EVIDENCE OF PRESUMPTIVE ELIGIBILITY. PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE: 1) PATIENT RECEIVING FREE CARE FROM A COMMUNITY CLINIC AND IS REFERRED TO THE HOPSITAL; 2) STATE-FUNDED PRESCRIPTION PROGRAMS; 3) HOMELESS, INDIGENT, OR HOMELESS CLINIC PATIENT; 4) PATIENT'S CHILDREN WHO QUALIFY FOR OTHER FINANCIAL ASSISTANCE PROGRAMS; 5) PATIENT ELIGIBLE FOR FOOD STAMPS; 6) MEDICAID ELIGIBLE PATIENT; 7) PATIENT IS DECEASED WITH NO KNOWN RESPONSIBLE PARTY; 8) PATIENT IS INCARCERATED AND HAS NO OTHER RESPONSIBLE PARTY.
Schedule H (Form 990) 2019
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Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
Our Lady of the Lake Hospital Inc
 
Employer identification number
72-0423651
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC section
(if applicable)		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
noncash assistance		 (h) Purpose of grant
or assistance
(1) BREADA
P O Box 3975
Baton Rouge,LA70821 		72-1332566 501(C)(3) 20,000       General Support
(2) City Year Inc
287 Columbia Avenue
Boston,MA021165114 		22-2882549 501(C)(3) 20,000       General Support
(3) Fore Kids Foundation
11005 Lapalco Blvd
Avondale,LA70094 		58-1940111 501(C)(3) 45,000       General Support
(4) McCains Childrens Development Center
1805 College Drive
Baton Rouge,LA70808 		72-0459036 501(C)(3) 10,000       General Support
(5) The Emerge Center
7784 Innovation Park Dr
Baton Rouge,LA70820 		45-5434705 501(C)(3) 13,500       General Support
(6) American Heart Association
7272 Greenville Avenue
Dallas,TX752314596 		13-5613797 501(C)(3) 65,500       General Support
(7) Livingston Economic Development Council
P O Box 809
Livingston,LA70754 		72-0966247 501(C)(6) 15,000       See Part IV
(8) Livingston Parish Chamber of Commerce
248 Veterans Blvd
Denham Springs,LA70726 		72-0632651 501(C)(6) 6,645       See Part IV
(9) HEALTH CARE CENTERS IN SCHOOLS
4336 North Boulevard
Baton Rouge,LA70806 		72-1443935 501(C)(3) 2,900,000       General Support
(10) FRANCISCAN MISSIONARIES OF OUR LADY UNIVERSITY
5000 Hennessy Boulevard
Baton Rouge,LA70808 		72-1173156 501(C)(3) 1,250,004       General Support
(11) OLOL FOUNDATION
5000 Hennessy Boulevard
Baton Rouge,LA70808 		72-1014324 501(C)(3) 1,200,000       General Support
(12) Ascension Chamber of Commerce
PO Box 1204
Gonzales,LA70707 		72-0701121 501(C)(6) 11,200       See Part IV
(13) Baton Rouge Area Foundation
100 North Street Ste 900
Baton Rouge,LA70802 		72-6030391 501(C)(3) 15,000       GENERAL SUPPORT
(14) BROC Foundation Inc
8080 Bluebonnet Blvd Ste1000
Baton Rouge,LA70810 		46-1941501 501(C)(3) 59,549       GENERAL SUPPORT
(15) City of Walker
PO Box 217
Walker,LA70785 		72-6013067 GOVT 12,000       See Part IV
(16) The JL Foundation
21223 Water Front East Dr
Maurepas,LA70449 		75-2976320 501(C)(3) 10,000       GENERAL SUPPORT
(17) The Walls Project
458 America St
Baton Rouge,LA70802 		45-5485171 501(C)(3) 10,000       GENERAL SUPPORT
(18) Volunteer Ascension
PO Box 1564
LSU Unit
Gonzales,LA707071564 		73-1376404 501(C)(3) 9,175       General Support
(19) Baton Rouge Area Chamber
564 Laurel St
Baton Rouge,LA70801 		72-0126959 501(C)(6) 12,500       See Part IV
(20) Baton Rouge Health District
5246 Brittany Dr
Baton Rouge,LA70808 		47-2593574 501(C)(3) 150,000       General support
(21) FRANCISCAN MISSIONARIES OF OUR LADY HEALTH SYSTEM
4200 ESSEN LANE
BATON ROUGE,LA70809 		72-1028323 501(C)(3) 12,000       INDIVIDUAL DISASTER ASSISTANCE
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
15
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
5
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2019

Schedule I (Form 990) 2019
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients		 (c) Amount of
cash grant		 (d) Amount of
noncash assistance		 (e) Method of valuation (book,
FMV, appraisal, other)		 (f) Description of noncash assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
Monitoring grants FORMAL REQUESTS ARE RECEIVED BY THE BUSINESS PAYOR RELATIONS DEPARTMENT, ARE CHECKED FOR ALL APPROPRIATE INFORMATION, AND ARE PRESENTED TO EXECUTIVE ADMINISTRATION FOR APPROVAL. THE HOSPITAL GIVES GRANTS TO ORGANIZATIONS WELL-KNOWN IN THE COMMUNITY, OR WHICH IT HAS A HISTORY OF GIVING TO. THE HOSPITAL FOLLOWS UP WITH GRANT RECIPIENTS IF THERE IS AN INDICATION OF POTENTIAL THAT THE FUNDS ARE NOT BEING USED FOR CHARITABLE PURPOSES.
PART II, COLUMN (H) - PURPOSE OF GRANTS OR ASSISTANCE LIVINGSTON PARISH CHAMBER OF COMMERCE: EDUCATION INITIATIVES SPONSOR, LIVE 2 LEAD PROGRAM TICKET, BUSINESS EXPO SPONSOR, MEETINGS, GALA BATON ROUGE AREA CHAMBER: "THINK BIGGER" PLEDGE, 2018 CANVAS LUNCH SPONSOR LIVINGSTON ECONOMIC DEVELOPMENT COUNCIL: LEDC LIVINGSTON TOMORROW INVESTMENT ASCENSION CHAMBER OF COMMERCE: SPONSOR FOR EVENTS, LEADERSHIP HEALTHCARE SESSION, BUSINESS EXPO CITY OF WALKER: DONATION FOR OUTDOOR EXERCISE AT SIDNEY HUTCHINSON PARK - COOPERATIVE ENDEAVOR
Schedule I (Form 990) 2019



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Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
Our Lady of the Lake Hospital Inc
 
Employer identification number

72-0423651
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ..
2
 
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? .............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2019

Schedule J (Form 990) 2019
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation in column (B) reported as deferred on prior Form 990
(i) Base
compensation 		(ii) Bonus & incentive
compensation 		(iii) Other reportable compensation
1DR JAMES CRAVEN
BOARD MEMBER/PHYSICIAN 		(i)

(ii)		 341,169
-------------
  		25,163
-------------
  		21,594
-------------
  		11,200
-------------
  		5,876
-------------
  		405,002
-------------
  		 
-------------
 
2STEVEN T GREMILLION
SVP, Chief Medical Officer 		(i)

(ii)		 326,652
-------------
  		624,684
-------------
  		2,402
-------------
  		11,200
-------------
  		20,616
-------------
  		985,554
-------------
  		 
-------------
 
3DENZIL L MORAES
STAFF PHYSICIAN 		(i)

(ii)		 807,442
-------------
  		459,675
-------------
  		1,218
-------------
  		11,200
-------------
  		23,480
-------------
  		1,303,015
-------------
  		 
-------------
 
4K SCOTT WESTER
CEO 		(i)

(ii)		  
-------------
680,881 		 
-------------
397,346 		 
-------------
140,283 		 
-------------
208,896 		 
-------------
29,685 		 
-------------
1,457,091 		 
-------------
119,260
5NORMAN J DEUMITE
STAFF PHYSICIAN 		(i)

(ii)		 594,032
-------------
  		379,461
-------------
  		6,352
-------------
  		11,200
-------------
  		16,095
-------------
  		1,007,140
-------------
  		 
-------------
 
6Nicole S Telhiard
SVP Patient Care Services 		(i)

(ii)		 299,003
-------------
  		71,826
-------------
  		811
-------------
  		50,669
-------------
  		25,442
-------------
  		447,751
-------------
  		 
-------------
 
7Paul M Dampf
STAFF PHYSICIAN 		(i)

(ii)		 421,150
-------------
  		787,815
-------------
  		477
-------------
  		11,200
-------------
  		28,050
-------------
  		1,248,692
-------------
  		 
-------------
 
8Paul D Garrett
STAFF PHYSICIAN 		(i)

(ii)		 565,048
-------------
  		435,262
-------------
  		794
-------------
  		11,200
-------------
  		28,179
-------------
  		1,040,483
-------------
  		 
-------------
 
9Charles A Smith
STAFF PHYSICIAN 		(i)

(ii)		 775,201
-------------
  		308,432
-------------
  		794
-------------
  		11,200
-------------
  		27,256
-------------
  		1,122,883
-------------
  		 
-------------
 
10Laurinda Calongne
VP CHIEF ACADEMIC OFFICER 		(i)

(ii)		 273,849
-------------
  		65,357
-------------
  		1,176
-------------
  		11,200
-------------
  		10,471
-------------
  		362,053
-------------
  		 
-------------
 
11John Fraiche MD
BOARD MEMBER 		(i)

(ii)		 499,396
-------------
  		679
-------------
  		1,809
-------------
  		11,200
-------------
  		3,591
-------------
  		516,675
-------------
  		 
-------------
 
12Shaun M Kemmerly
VP CHIEF MEDICAL OFFICER 		(i)

(ii)		 342,200
-------------
  		60,418
-------------
  		2,402
-------------
  		11,200
-------------
  		24,586
-------------
  		440,806
-------------
  		 
-------------
 
13Stephanie Manson
SVP, Chief Operating Officer 		(i)

(ii)		 380,528
-------------
  		135,885
-------------
  		817
-------------
  		48,926
-------------
  		26,567
-------------
  		592,723
-------------
  		 
-------------
 
14Alston Dunbar
President of Children's Hospit 		(i)

(ii)		 367,957
-------------
  		79,984
-------------
  		4,033
-------------
  		11,200
-------------
  		22,103
-------------
  		485,277
-------------
  		 
-------------
 
15Terrie P Sterling
Former COO 		(i)

(ii)		 217,878
-------------
  		120,154
-------------
  		328,816
-------------
  		60,178
-------------
  		18,974
-------------
  		746,000
-------------
  		308,767
-------------
 
16JEFF LIMBOCKER
CFO/EVP 		(i)

(ii)		  
-------------
550,613 		 
-------------
293,047 		 
-------------
55,135 		 
-------------
135,652 		 
-------------
25,745 		 
-------------
1,060,192 		 
-------------
45,920
Schedule J (Form 990) 2019

Schedule J (Form 990) 2019
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
PART 1, QUESTION 4B FMOLHS MAINTAINS THREE UNFUNDED DEFERRED COMPENSATION PLANS WHICH MEET THE REQUIREMENTS OF IRC SECTION 457(F) AND IRC SECTION 409A. THE PLAN PROVIDES FOR COMPENSATION TO BE DEFERRED AND PAID UPON THE OCCURRENCE OF CERTAIN EVENTS SUCH AS TERMINATION WITHOUT CAUSE, DISABILITY, DEATH OR ATTAINMENT OF A SPECIFIC PAYMENT DATE. PARTICIPATION IN THE PLAN IS LIMITED TO CERTAIN EXECUTIVES AND IS SUBJECT TO APPROVAL OF FMOLHS BOARD OF DIRECTORS OR A DESIGNATED COMMITTEE OF SUCH BOARD. DURING THE CURRENT YEAR, THE FOLLOWING INDIVIDUALS RECEIVED PAYMENTS FROM THE PLANS - K. SCOTT WESTER $137,584; TERRIE STERLING $326,775
PART 1, QUESTION 3 THE CEO IS PAID BY FMOL HEALTH SYSTEM, A RELATED TAX EXEMPT ORGANIZATION. THE FMOLHS BOARD OF DIRECTORS DESIGNATES A COMPENSATION COMMITTEE, MADE UP OF INDEPENDENT BOARD MEMBERS, TO REVIEW AND SET THE CEO'S COMPENSATION ANNUALLY. THE COMPENSATION COMMITTEE OBTAINS AND RELIES UPON COMPARABLE DATA INCLUDING A COMPENSATION STUDY/SURVEY FROM AN INDEPENDENT COMPENSATION CONSULTANT. THE COMPENSATION COMMITTEE REVIEWS COMPENSATION PACKAGES AND APPROPRIATE COMPENSATION IS DETERMINED AND APPROVED. THE BASIS FOR MAKING SUCH DETERMINATION IS DOCUMENTED BY THE COMPENSATION COMMITTEE.
PART 1, QUESTION 4A THE CEO AND CFO ARE ENTITLED TO A SEVERANCE BENEFIT. THE PAYOUT OF SUCH BENEFIT IS REMOTE AS IT IS EFFECTIVE ONLY FOR TERMINATION OF EMPLOYMENT WITHOUT CAUSE FOR GOOD REASON AND FOR A CHANGE OF CONTROL. IF TRIGGERED, THE EXECUTIVE WOULD BE PAID HIS/HER BASE SALARY AND AN ANNUAL INCENTIVE AT TARGET AND PROVIDED RETIREMENT AND WELFARE BENEFITS FOR AN ENTITLEMENT PERIOD. THE ENTITLEMENT PERIOD IS 24 MONTHS. NO PAYMENTS WERE MADE UNDER THE PLAN IN THE CURRENT YEAR.
Schedule J (Form 990) 2019

Additional Data


Software ID:  
Software Version:  
SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
Our Lady of the Lake Hospital Inc
 
Employer identification number

72-0423651
Return Reference Explanation
GOVERNING DOCUMENTS PART VI, SECTION C, QUESTION 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST.
PART VI, SECTION A, QUESTION 6 FMOL HEALTH SYSTEM (AN IRC SECTION 501 (C)(3) ORGANIZATION) IS THE SOLE MEMBER OF OUR LADY OF THE LAKE HOSPITAL, INC.
MEMBERS PART VI, SECTION A, QUESTION 7B THE RESERVED POWERS TO THE MEMBER ARE AS FOLLOWS: 1. TO CHANGE PHILOSOPHY, OBJECTIVES AND PURPOSES OF CORPORATION 2. TO APPOINT OR REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES AND OFFICERS OF THE CORPORATION 3. TO AMEND, ALTER, MODIFY OR REPEAL THE ARTICLES OF INCORPORATION AND BYLAWS OF THE CORPORATION 4. TO AUTHORIZE MERGER, CONSOLIDATION, OR AFFILIATION, OR PARTICIPATE IN JOINT VENTURES 5. TO DISSOLVE AND TO DISTRIBUTE ASSETS OF THE CORPORATION 6. TO APPOINT AND/OR TERMINATE WITH OR WITHOUT CAUSE THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION 7. TO ACQUIRE, PURCHASE, SELL, LEASE, TRANSFER, OR ENCUMBER ANY IMMOVABLE PROPERTY ON BEHALF OF THE CORPORATION 8. TO ADD TO OR INCUR LONG-TERM DEBT IN EXCESS OF $5 MILLION BY THE CORPORATION 9. TO APPOINT THE FISCAL AUDITOR FOR THE CORPORATION 10. TO APPROVE ANY INCREMENT OR ADDITION TO THE CAPITAL DEBT OR EFFORTS TO RENEGOTIATE, MODIFY OR CHANGE THE EXISTING CAPITAL DEBT OBLIGATIONS OF THE CORPORATION 11. TO APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE CORPORATION AND 12. TO APPROVE A STRATEGIC BUSINESS PLAN OF THE CORPORATION
CONFLICT OF INTEREST OUR LADY OF THE LAKE HOSPITAL, INC. HAS A COMPREHENSIVE CONFLICT OF INTEREST POLICY THAT REQUIRES EACH OFFICER, TRUSTEE, BOARD COMMITTEE MEMBER AND EMPLOYEE TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. COMPLETED DISCLOSURE FORMS ARE REVIEWED AND MAINTAINED BY THE CHIEF COMPLIANCE OFFICER. IF ANY TRUSTEE, BOARD COMMITTEE MEMBER OR SENIOR MANAGER HAS A POTENTIAL CONFLICT, THE EXECUTIVE COMMITTEE OF THE BOARD DETERMINES WHETHER ACTION NEEDS TO BE TAKEN AND COMMUNICATES ANY SUCH ACTION TO THE INDIVIDUAL. A POTENTIAL CONFLICT OF ANY OTHER EMPLOYEE IS REVIEWED BY THE CEO OR HIS DESIGNEE. THE EXECUTIVE COMMITTEE, CEO OR DESIGNEE, AS APPLICABLE, DETERMINES IF A CONFLICT OF INTEREST EXISTS OR CREATES THE APPEARANCE OF IMPROPRIETY. IF SUCH A DETERMINATION IS MADE, THE INDIVIDUAL WILL BE EXCUSED FROM PARTICIPATING IN THE BUSINESS DECISION. DURING THE YEAR, ANY CHANGE TO THE INFORMATION IN THE DISCLOSURE STATEMENT MUST BE DISCLOSED PROMPTLY TO THE CHIEF COMPLIANCE OFFICER, WHO TAKES APPROPRIATE ACTION. THE PROCESS ALSO REQUIRES AFFIRMATION FROM EACH INDIVIDUAL THAT HE OR SHE (A) HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY; (B) HAS READ AND UNDERSTANDS THE POLICY; (C) HAS AGREED TO COMPLY WITH THE POLICY AND (D) UNDERSTANDS THAT OUR LADY OF THE LAKE HOSPITAL IS A CHARITABLE ORGANIZATION AND THAT, IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST ENGAGE IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX EXEMPT PURPOSES. IN ADDITION TO THE ABOVE, OUR LADY OF THE LAKE HOSPITAL, INC. PROVIDES MECHANISMS FOR CONFIDENTIAL REPORTING OF COMPLIANCE ISSUES. THESE MECHANISMS INCLUDE AN ANONYMOUS HOTLINE AND WEB SITE WHERE INDIVIDUALS MAY RAISE ISSUES, SEEK CLARIFICATION AND REPORT POSSIBLE CONFLICTS OF INTEREST OR OTHER CONCERNS. THESE REPORTS, INCLUDING REPORTS OF POSSIBLE CONFLICTS OF INTEREST ARE REVIEWED AND INVESTIGATED BY THE CORPORATE COMPLIANCE DEPARTMENT AND APPROPRIATE ACTION IS TAKEN.
PART VI, SECTION A, QUESTION 11 AFTER PREPARATION AND REVIEW OF THE FORM 990 BY KPMG, THE FORM 990 IS REVIEWED BY MANAGEMENT. A COPY OF THE FORM 990 IS PROVIDED TO THE ORGANIZATION'S GOVERNING BODY BEFORE IT IS FILED WITH THE IRS.
PART VI, SECTION A, QUESTION 7A FMOL HEALTH SYSTEM, AS THE SOLE MEMBER OF OUR LADY OF THE LAKE HOSPITAL, INC. RETAINS THE POWER TO APPOINT AND REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES AND OFFICERS OF OUR LADY OF THE LAKE Hospital, Inc.
DETERMINING COMPENSATION PART VI, SECTION B, QUESTION 15A & 15B OUR BOARD OF DIRECTORS DESIGNATES A COMPENSATION COMMITTEE MADE UP OF INDEPENDENT BOARD MEMBERS TO REVIEW AND SET THE COMPENSATION ANNUALLY OF OUR OFFICERS AND KEY EMPLOYEES. THE COMPENSATION COMMITTEE OBTAINS AND RELIES UPON COMPARABLE DATA INCLUDING INDUSTRY-WIDE COMPENSATION INFORMATION PROVIDED BY OUTSIDE SOURCES. THE COMPENSATION COMMITTEE REVIEWS COMPENSATION PACKAGES AND APPROPRIATE COMPENSATION IS DETERMINED AND APPROVED. THE BASIS FOR DETERMINATION IS THEN DOCUMENTED BY THE COMPENSATION COMMITTEE. THE COMPENSATION FOR THE CEO OF OUR LADY OF THE LAKE HOSPITAL, INC. IS SET BY THE COMPENSATION COMMITTEE OF FMOL HEALTH SYSTEM (A RELATED TAX-EXEMPT ORGANIZATION) ACCORDING TO THEIR PAY PRACTICES WHICH ARE SIMILAR TO THOSE DESCRIBED ABOVE.
Part XI, Line 9 Other Changes in net assets or fund balances: Capital Transfers ($26,746,844)
SECTION 1.263(A)-3(N) - BOOK CONFORMITY ELECTION OUR LADY OF THE LAKE HOSPITAL, INC. IS MAKING THE ELECTION UNDER TREAS. REG. 1.263(A)-3(N) TO CAPITALIZE THE REPAIR AND MAINTENANCE COSTS THAT IT TREATS AS CAPITAL IMPROVEMENTS ON ITS BOOKS AND RECORDS FOR THE TAX YEAR ENDED JUNE 30, 2020.
SECTION 1.263 (A)-1(F) - DE MINIMIS SAFE HARBOR ELECTION OUR LADY OF THE LAKE HOSPITAL, INC. HEREBY MAKES THE DE MINIMIS SAFE HARBOR ELECTION UNDER SECTION 1.263(A)-1(F) OF THE TREASURY REGULATIONS, EFFECTIVE ONLY FOR THE TAX YEAR ENDING JUNE 30, 2020. TAXPAYER HAS AN APPLICABLE FINANCIAL STATEMENT FOR THE YEAR OF THE ELECTION. THIS ELECTION PERMITS THE TAXPAYER TO DEDUCT FOR TAX PURPOSES ANY ITEM DEDUCTED UNDER ITS BOOK POLICY THAT DOES NOT EXCEED $5,000 PER INVOICE (OR PER ITEM, AS SUBSTANTIATED BY THE INVOICE) OR ITEMS HAVING AN ECONOMIC USEFUL LIFE OF TWELVE MONTHS OR LESS AS DESCRIBED IN SECTION 1.263(A)-1(F)(1)(I).
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2019


Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
Our Lady of the Lake Hospital Inc
 
Employer identification number

72-0423651
Part I
Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity
(1) OUR LADY OF THE LAKE PHYSICIANS GROUP
5000 HENNESSY BLVD
BATON ROUGE,LA70808
27-4026658 		HEALTHCARE LA 272,690,161 37,317,847 OLOL
 
(2) PERKINS PLAZA IMAGING DEVELOPMENT LLC
5000 HENNESSY BLVD PLAZA 2 SUITE
BATON ROUGE,LA70808
20-3894521 		REAL ESTATE LA 704,669 7,762,728 OLOL
 








Part II
Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No
(1)HEALTH CARE CENTERS IN SCHOOLS
4200 Essen Lane

BATON ROUGE,LA70809
72-1443935 		HEALTHCARE LA 501(C)(3) 10 OLOL
 
Yes
 
(2)ST BERNARD HEALTH FUND
4200 Essen Lane

BATON ROUGE,LA70809
20-4685614 		HEALTHCARE LA 501(C)(3) 12 TYPE 1 FMOL
 
 
No
(3)ST DOMINIC HEALTH SERVICES INC
969 LAKELAND DRIVE

JACKSON,MS39216
64-0714999 		HOLDING CO MS 501(C)(3) 12 TYPE 3FI NA
 
 
No
(4)COMMUNITY HEALTH SERVICES - ST DOMINIC
969 LAKELAND DRIVE

JACKSON,MS39216
64-0884870 		Health progra MS 501(C)(3) 10 SDHS
 
 
No
(5)ST DOMINIC - JACKSON MEMORIAL HOSPITAL
969 LAKELAND DRIVE

JACKSON,MS39216
64-0303091 		HOSPITAL MS 501(C)(3) 3 SDHS
 
 
No
(6)ST DOMINIC - HEALTH SERVICES FOUNDATION
969 LAKELAND DRIVE

JACKSON,MS39216
43-1992975 		FUNDRAISING MS 501(C)(3) 7 SDHS
 
 
No
(7)ST CATHERINE'S VILLAGE INC
969 LAKELAND DRIVE

JACKSON,MS39216
64-0714997 		RET HOME MS 501(C)(3) 10 SDHS
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) LOURDES IMAGING DEVELOPMENT LLC

4801 AMBASSADOR CAFFERY PKWY
LAFAYETTE,LA70508
20-8326287 		REAL ESTATE LA LOURDES
  		N/A                
(2) PARK PLACE SURGERY CENTER LLC

4811 AMBASSADOR CAFFERY PKWY
LAFAYETTE,LA70508
72-1404092 		HEALTHCARE LA LOURDES
  		N/A                
(3) BRPT LAKE REHABILITATION CENTERS LLC

175 S ENGLISH STATION RD STE 218
LOUISVILLE,KY40245
72-1506100 		HEALTHCARE LA OLOL
  		RELATED 60,314 2,499,425   No 0 Yes   15.000 %
(4) CONVENIENT CARE LLC

10319 JEFFERSON HIGHWAY
BATON ROUGE,LA70809
72-1439481 		HEALTHCARE LA OLOL
  		RELATED 1,353,435 2,745,327   No 0 Yes   50.000 %
(5) SURGICAL SPECIALTY CENTER OF BATON ROUGE

8080 BLUEBONNET BLVD
BATON ROUGE,LA70810
26-3120962 		HEALTHCARE LA OLOL
  		RELATED 7,610,019 30,137,618   No 0 Yes   49.000 %
(6) ST ELIZABETH-MARY BIRD PERKINS CANCER C

4950 ESSEN LANE
BATON ROUGE,LA70809
26-0628752 		HEALTHCARE LA OLOL
  		RELATED   3,459,731   No 0 Yes   35.000 %
(7) NORTHEAST LA CANCER INSTITUTE LLC

411 CALYPSO STREET
MONROE,LA71201
72-1329499 		HEALTHCARE LA SFMC
  		N/A                
(8) LHCG-XIII LLC dba Lourdes Home Health

901 S HUGH WALLIS ROAD
LAFAYETTE,LA70508
20-8068308 		HEALTHCARE LA LOURDES
  		N/A                
(9) LOURDES AFTER HOURS LLC

7777 HENNESSY BLVD SUITE 1004-202
BATON ROUGE,LA70809
20-1367299 		HEALTHCARE LA LOURDES
  		N/A                
(10) LAKE URGENT CARE ASCENSION LLC

10319 JEFFERSON HIGHWAY
BATON ROUGE,LA70809
35-2463092 		HEALTHCARE LA OLOL
  		RELATED 376,545 695,170   No 0 Yes   67.000 %
(11) OLOLUSP SURGERY CENTER LLC

15305 DALLAS PKWY STE 1600 LB 28
ADDISON,TX75001
35-2457810 		HEALTHCARE TX OLOL
  		RELATED 1,239,661 19,397,510   No 0 Yes   51.000 %
(12) ST FRANCIS URGENT CARE LLC

10319 JEFFERSON HIGHWAY
BATON ROUGE,LA70809
47-4013731 		HEALTHCARE LA SFMC
  		N/A                
(13) GAMMA KNIFE OF LOUISIANA LLC

4950 ESSEN LANE
BATON ROUGE,LA70809
81-1827194 		HEALTHCARE LA OLOL
  		RELATED -65,809 1,387,111   No 0 Yes   50.000 %
(14) LHCG LXVII LLC

901 S HUGH WALLIS ROAD
LAFAYETTE,LA70508
47-4283509 		HEALTHCARE LA LOURDES
  		N/A                
(15) PREMIER HEALTH HOLDINGS LLC

10319 JEFFERSON HIGHWAY
BATON ROUGE,LA70809
47-2665226 		HEALTHCARE LA OLOL
  		RELATED -262,847 3,978,501   No 0 Yes   50.000 %
(16) PINNACLE CARE HOLDINGS LLC

5627 S SHERWOOD FOREST BLVD
BATON ROUGE,LA70816
82-1637627 		HEALTHCARE LA OLOL
  		RELATED 1,277,015 4,960,032   No 0 Yes   84.000 %
(17) LAFAYETTE SURGERY CENTER LIMITED PARTNER

C/O C T CORPORATION SYSTEM 3867 PL
BATON ROUGE,LA70816
72-0423635 		HEALTHCARE LA LOURDES
  		N/A                
(18) HIGHLAND MEDICAL ARTS LLC

PO BOX 55769
JACKSON,MS39216
74-3073171 		MED BUILDING MS SDHS
  		N/A                
(19) D1 SPORTS TRAINING OF MISSISSIPPI LLC

7715 SOUTH SPRINGS DRIVE
FRANKLIN,TN37067
27-5277568 		ATHLETIC CENTER MS SDMHS
  		N/A                
(20) MEA PRIMARY CARE PLUS LLC

308 CORPORATE DRIVE
RIDGELAND,MS39211
 HEALTHCARE MS FIC
  		N/A                
(21) FREMAUX OFFICE MM LLC

3500 NORTH CAUSEWAY BOULEVARD STE
METAIRIE,LA70002
 HEALTHCARE LA FMOLHS
  		N/A                
(22) FREMAUX MOB LLC

3500 NORTH CAUSEWAY BOULEVARD STE
METAIRIE,LA70002
 MED BLDG LA FMOLHS
  		N/A                
(23) HEART HOSPITAL OF ACADIANA LLC

1105 KALISTE SALOOM ROAD
LAFAYETTE,LA70511
 HEALTHCARE LA LOURDES
  		N/A                
(24) SHP MANAGING MEMBER LLC

7015 HIGHWAY 190 E SERVICE ROAD
BATON ROUGE,LA70816
 HEALTHCARE LA OLOL
  		N/A                
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) HOSPITAL ASSISTANCE SERVICES

4200 ESSEN LANE
BATON ROUGE,LA70809
72-1073486 		HEALTHCARE LA LOURDES
  		C CORP          
(2) LOUISE INSURANCE COMPANY

PO BOX 1051 KY1-1102
CAYMAN ISLANDS,GRAND CAYMAN  
CJ
INSURANCE CJ FMOL
  		C CORP          
(3) FRANCISICAN HEALTH & WELLNESS SERVICES

4200 ESSEN LANE
BATON ROUGE,LA70809
45-5492379 		HEALTHCARE LA FMOL
  		C CORP          
(4) FMOL HEALTH SYSTEM HOLDINGS INC

4200 ESSEN LANE
BATON ROUGE,LA70809
45-4405024 		INVESTMENT LA FMOL
  		C CORP          
(5) ST DOMINIC MADISON HEALTH SERVICES INC

969 LAKELAND DRIVE
JACKSON,MS39216
20-2870254 		HEALTHCARE MS SDHS
  		C CORP          
(6) FIRST INTERMED CORPORATION

308 CORPORATE DRIVE
RIDGELAND,MS39157
64-0824796 		MEDICAL SERVICES MS SDHS
  		C CORP          
(7) ST DOMINIC INTEGRATED SERVICES INC

969 LAKELAND DRIVE
JACKSON,MS39216
27-1493623 		INVESTMENTS MS SDJMH
  		C CORP          
(8) LAFAYETTE SURGICARE INC

C/O C T CORP SYS 3867 PLAZA TOWER
BATON ROUGE,LA70816
 HEALTHCARE LA LOURDES
  		C CORP          
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
Page 3
Part V
Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
Yes
 
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) PINNACLE CARE HOLDINGS

 S 1,546,744 FMV
(2) GAMMA KNIFE OF LOUISIANA

 S 319,500 FMV
(3) BRPT - LAKE REHABILITATION CENTER

 S 60,137 FMV
(4) SURGICAL SPECIALTY CENTER OF BATON ROUGE

 S 7,144,126 FMV
(5) SHP MANAGING MEMBER

 S 312,416 FMV

Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2019

Additional Data


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